ProMED-mail post

Published Date: 2010-08-07 23:00:17
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2010 (13): Africa
Archive Number: 20100807.2695

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (13): AFRICA
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In this update:
[1] Cholera - Cameroon (Far North)
[2] Cholera - Angola
[3] Cholera - Nigeria (Bauchi)
[4] Cholera - Somalia (Bay)
[5] Cholera - Somalia (WHO report May 2010)
[6] Cholera - Kenya
[7] Cholera - Guinea Bissau (Bafata)
[8] Cholera - Zimbabwe (Manicaland)

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[1] Cholera - Cameroon (Far North)
Date: Fri 6 Aug 2010
Source: UN ReliefWeb, Int Fed of Red Cross And Red Crescent Societies
(IFRC) report [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900sid/FERB-883J9R/$File/full_report.pdf>

Since May 2010, the Far North Region of Cameroon has experienced a
severe cholera outbreak, the country's biggest outbreak in the last
10 years. As far as epidemiology is concerned, the Far North Region
of Cameroon is a high risk area. The last cholera outbreak occurred
in October 2009, recording 366 cases, 44 deaths, and affected 11
health districts in the region. The last cholera case was reported in
December 2009.

On 6 May 2010, the chief of the health service at Makary district
reported cases of diarrhea and vomiting, which were investigated at
the Ngouna Integrated Health Center (IHC). The IHC confirmed the 1st
cholera case on 6 May 2010. Until May 28 2010, all the cases
registered were in the Makary and Mada health districts of Far North
Region, which were not affected during the 2009 outbreak. Since then,
Mogode and Kousseri have also been affected. On 12 Jul 2010, 8 health
districts were already affected by cholera, while 4 new health
districts were affected as from 13 Jul 2010, namely Hina, Kolofata,
Roua, and Kay-hay health districts.

By 1 Aug 2010, 14 health districts out of the 28 that make up the Far
North Region of Cameroon were affected. A total of 456 cases of
cholera and 109 deaths have been registered, with a 7.5 percent case
fatality rate (CFR).

A cholera outbreak is current in Mogode, Kousseri, Makary, Meri,
Guere, Mokolo, Kolofata, Koza, Hina, Roua, Kay-hay, Mada, Yagoua, and
Tokombere health districts of the Far North Region of Cameroon.

So far, a total of 1456 cases of cholera and 109 deaths have already
been registered. Since the start of the operation, the cholera
outbreak has spread over the Far North Region of Cameroon, making the
entire population of that region extremely vulnerable. This
population is estimated at 3 480 000 people.

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[A map showing the regions of Cameroon can be accessed at
<http://www.lib.utexas.edu/maps/africa/cameroon_pol98.jpg>. The
HealthMap/ProMED mail interactive map of the country can be seen at
<http://healthmap.org/r/00Yv>. - Sr.Tech.Ed.MJ]

******
[2] Cholera - Angola
Date: Thu 5 Aug 2010
Source: Angola Press Agency (Angop) [edited]
<http://www.portalangop.co.ao/motix/en_us/noticias/saude/2010/7/31/Angola-registers-over-000-cholera-cases-first-half,13211640-35a0-4c9b-ade5-47a0a166112a.html>

At least 1477 cholera cases were reported in the country, according
to information released by the Processing Centre of Epidemiologic
Data of the National Management of Public Health.

This information comes expressed in an assessment report of the
institution released to Angola Press this Thursday [5 Aug 2010], and
mentions that in the 1st half of 2010 an increase of 218 cases of
cholera was reported, against 1240 patients notified in 2009.

According to the document, among the notified cases, 34 resulted in death.

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[Maps of Angola are available at
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf> and the
HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00BZ>. - Sr.Tech.Ed.MJ]

******
[3] Cholera - Nigeria (Bauchi)
Date: Mon 26 Jul 2010
Source: Nigerian Bulletin, Daily Independent (Nigeria) report [edited]
<http://nigerianbulletin.com/2010/07/26/fresh-cholera-outbreak-kills-six-in-bauchi-daily-independent/>

So far, 6 people have been confirmed dead and at least 160 infected
following the outbreak of diarrhea due to cholera in some parts of
Bauchi metropolis. This was disclosed by the Commissioner of Health,
Mohammed Yahaya Jalam, to Sunday Independent in his office on Fri 23
Jul 2010. According to him, out of the 160 people infected, 100 have
been treated at the Abubakar Tafawa Balewa Teaching Hospital, Bauchi,
and discharged while the remaining 60 are still receiving treatment.

A South African company, Zenith Water Projects, has donated cholera
eradication materials to Adamawa and Taraba states to curtail the
spread of the disease. Chief executive officer of the company,
Nicholas Igwe, presented the items to the minister of Water
Resources, Obadiah Ando, in Abuja.

[Byline: Bunmi Awolusi]

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[A map showing the states in Nigeria can be seen at
<http://en.wikipedia.org/wiki/States_of_Nigeria>. The
HealthMap/ProMED mail interactive map of Nigeria can be accessed at
<http://healthmap.org/r/01MI>. - Sr.Tech.Ed.MJ]

******
[4] Cholera - Somalia (Bay)
Date: Wed 21 Jul 2010
Source: Suna Times [edited]
<http://www.sunatimes.com/view.php?id=279>

A total of 7 children under the age of 10 are reported to have died
in the Labatan Jirow district in the Bay region of southern Somalia.
It is believed that an outbreak of cholera has caused the death of
the minors. 12 other children are currently suffering from the
waterborne disease in the same district. The deaths have been
reported and recorded in the last 12 hours [21 Jul 2010] only.

Sheikh Hassan Abdi Nur, who is the district commissioner of Labatan
Jirow, told the press in Baidabo that the number of people affected
by cholera in the district is increasing. He said the outbreak of the
disease has become a great worry for both residents and his administration.

Sheikh Hassan, who is also known as Sheikh Saydheelow, also said that
there are no medical facilities and services in the district. Most of
the patients, who are mainly children, have been taken to the Baidabo
General Hospital for treatment.

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******
[5] Cholera - Somalia (WHO report May 2010)
Date: 20 May 2010
Source: WHO Eastern Mediterranean Regional Office (EMRO) [edited]
<http://www.emro.who.int/somalia/pdf/Somalia%20Health%20Cluster%20Bulletin%20May%202010.pdf>

In epidemiological weeks 18-20 (3-23 May 2010), 204 sentinel sites of
the Communicable Diseases Surveillance and Reporting Network (CSR)
throughout Somalia reported 3103 AWD [acute watery diarrhea - Mod.LL]
cases including 76.6 percent children and 14 deaths (CFR 0.45
percent). South Central Zone alone accounted for 97 percent (3025) of
all AWD cases.

The integrated disease surveillance and response system (IDSR) in 7
districts of Lower and Middle Jubba reported 4252 consultations from
14 health facilities for 14 health events under surveillance. AWD
cases accounted for 833 consultations (76 percent of them children)
of all the consultations. Afmadow district accounted for 199 AWD
cases, Hagar (61), Kismaayo (233), Badhaadhe (58), Bu'aale (57),
Sakoow (61), and Salagle (57), Jilib (107). The data were not
available from Jamaame (Lower Jubba) during the reporting period due
to access challenges due to insecurity in the area.

On 20 May 2010, WHO received reports of an AWD outbreak in Jowhar
town in Middle Shabelle Region with a total of 8 cases including 6
adults and 2 deaths of patients under 5 years (CFR 25 percent). WHO
team visited Jowhar hospital where the cases had been referred.
Retrospective data of all AWD cases attended at the hospital from 8 -
24 May indicated that a total of 134 cases had been seen at the
hospital including (93) children under the age of 5 years and 2
deaths; one under the age of 5 (CFR 1.49). The rumored cases had not
been seen at the hospital as reported. Although the trends depicted
by the data collected do not necessarily describe an outbreak, Jowhar
is a high risk area for AWD outbreaks owing to the high population
density and IDPs in the area and the proximity to the Shabelle River,
which is also a major water source for residents. The number of cases
above 5 years is on the increase, a cause for vigilance. WHO is
therefore asking partners in the district to be alert and respond to
the situation as it evolves. Currently, there have been no samples
obtained from patients in Middle Shabelle Region.

In epidemiological weeks 18-21, Banadir Hospital (Mogadishu) reported
465 cases of cholera, including 84 percent (390) children. Of the 15
reported deaths (CFR 3.22), 10 were children. In week 13, WHO
received confirmation that 8 out of 19 samples (42 percent) tested
positive for _Vibrio cholerae_, serotype Inaba. During follow up
samples testing all 15 samples collected during week 20 tested
negative for cholera. Current trends indicate that the number of
reported cholera cases is still high and WHO continues top monitor
trends with view to revise the outbreak status.

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[As a short review, the flagellar (H) antigens of _V. cholerae_ are
shared with many water vibrios and, therefore, are of no use in
distinguishing strains causing epidemic cholera. The O (somatic)
antigens, however, do distinguish strains of _V. cholerae_ into 139
known serotypes. Almost all of these strains of _V. cholerae_ are
nonvirulent. Until the emergence of the Bengal (O139) strain (which
is "non-O1"), a single serotype, designated O1, has been responsible
for epidemic cholera.

There are 3 distinct O1 biotypes, named Ogawa, Inaba, and Hikojima,
each of which may display the "classical" or El Tor phenotype. The
biotypes are distinguished by their expression of surface antigens A,
B, and C. Ogawa contains antigens A and B; Inaba antigens A and C;
and Hikojima antigens A, B, and C. The latter serotype is relatively
rare. - Mod.LL]

[Maps of Somalia can be seen at
<http://en.wikipedia.org/wiki/Regions_and_Districts_of_Somalia> and
the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00aM>. - Sr.Tech.Ed.MJ]

******
[6] Cholera - Kenya
Date: Fri 9 Jul 2010
Source: UN ReliefWeb, Ministry of Public Health and Sanitation
(Kenya) report [edited]
<http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/MCOI-87ACE4-full_report.pdf/$File/full_report.pdf>

Beginning January 2010, outbreaks of cholera have cumulatively
affected 34 districts nationwide, causing a total of 3188 cases and
63 deaths (CFR o 2 percent). So far, the outbreaks have been
controlled in 29 districts. No new cases have been reported in the
month of July [2010] from the districts of Langata, Kilifi, Nakuru,
Kaloleni, and East Pokot, where cases have been reported in recent
weeks. In the last week [week ending 11 Jul 2010], no district has
reported new cases.

[The full report is available at the source URL above.]

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[The areas mentioned can be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>. The
HealthMap/ProMED-mail interactive map of Kenya can be accessed at
<http://healthmap.org/r/019e>. - Sr.Tech.Ed.MJ]

******
[7] Cholera - Guinea Bissau (Bafata)
Date: Thu 8 Jul 2010
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/201007080597.html>

Staff from NGOs and the health authorities are going house-to-house
to distribute thousands of bottles of bleach to residents in the
Bafata area of central Guinea-Bissau to prevent another cholera
outbreak. An epidemic in 2008 claimed at least 225 lives and infected
more than 13 000 people.

"We're doing everything possible to prevent a cholera outbreak this
year [2010]. The joint effort of communities and local authorities
has prevented many cases of cholera in the past, and efforts have
once again been stepped up," said Ingrid Kuhfeldt, country director
of Plan International, which works to alleviate child poverty.

Cholera is a waterborne disease that usually occurs during the rainy
season and spreads quickly in rural areas like the Bafata region,
where most people fetch their water from wells that are easily
contaminated, and it is not always stored in hygienic conditions.

This year [2010], the 1st rains fell in early June 2010, but so far,
no cholera cases have been recorded anywhere in Guinea-Bissau.
Kuhfeldt told IRIN this was partly the result of careful planning by
the government and aid agencies, a repetition of the strategy
implemented in 2009, when Bafata had no confirmed cases.

Plan International's cholera prevention methods include distributing
medical and cleaning supplies, like bleach and oral rehydration
sachets, sinking wells and building toilets.

An epidemic in 2005 infected 25 000 people, followed by an epidemic
in 2008, which prompted the Ministry of Health to swiftly order
laboratory tests for suspected cases of cholera this month [July
2010], but they proved negative.

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[Maps of Guinea Bissau can be seen at
<http://en.wikipedia.org/wiki/Regions_of_Guinea-Bissau> and the
HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/01Qd>. - Sr.Tech.Ed.MJ]

******
[8] Cholera - Zimbabwe (Manicaland)
Date: Fri 9 Jul 2010
Source: eFood Alert, The Herald (Zimbabwe) report [edited]
<http://efoodalert.blogspot.com/2010/07/outbreaks-and-alerts-july-9-2010.html>

A total of 4 cholera cases have been confirmed in Chiadzwa this week
[week ending 11 Jul 2010], with the victims reported to be panners
who had sneaked into the diamond fields. Officials from the Civil
Protection Unit and the Ministry of Health and Child Welfare
confirmed the outbreak on Wednesday [7 Jul 2010].

Some of the victims are said to be from Harare. CPU Manicaland
provincial head Mr Fungai Mbetsa said the 4 cases were reported on 28
Jun [2010] and confirmed on Monday [5 Jul 2010]. "The infected
people, who we believe to be panners, are being treated at Chishingwi Clinic.

"We are worried that some people are still finding their way into the
Chiadzwa diamond fields, which are a protected area." No deaths have
been recorded, and personnel from the Ministry of Health and Child
Welfare and other stakeholders are on the ground monitoring the situation.

Cholera cases were reported in Buhera and Mutambara earlier this year
[2010]. At least 25 cases and one death were confirmed in Buhera,
while 9 students from Lydia Chimonyo High School were treated at
Mutambara Mission Hospital after contracting the disease.

[Byline: Cletus Mushanawani]

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[A map showing the administrative regions of Zimbabwe can be accessed at
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>.
The HealthMap/ProMED-mail interactive map of Zimbabwe can be seen at
<http://healthmap.org/r/01Qe>. - Sr.Tech.Ed.MJ]

See Also